ANNUAL REPORT

Transcription

1 ANNUAL REPORT 2015

2 Contents Contents Letter from the Executive Director... 3 Background... 4 Board of Trustees... 5 Virginia Youth Survey... 6 VFHY at a Glance... 7 Weight of the State Conference... 8 Childhood Obesity Prevention... 9 Programs...14 Marketing...20 Research...27 Financial Statements...32 Notes to Financial Statements Virginia Foundation for Healthy Youth

3 Letter from the Executive Director Greetings! I am pleased to report to you that the Virginia Foundation for Healthy Youth continued to make a positive impact on the health of young people across Virginia during Y Street, our nationally recognized youth-led volunteer group for high school students, participated in several important initiatives this year, including our first 24/7 Tobacco-Free Spirit Day, held on Nov. 18, Virginia Lt. Gov. Ralph Northam, a former member of the VFHY Board of Trustees, helped us kick off this statewide celebration of tobacco-free schools with an event in Virginia Beach. With the help of Y Street volunteers who are speaking to their school boards and principals, more school systems across Virginia are adopting comprehensive, 100 percent tobacco-free schools policies, but there are still many more to go. Our Y Street youth also helped out on May 15, 2015, at our third annual Rev Your Bev Day, which raises awareness of the health effects of sugary drinks. Due in part to VFHY s efforts a growing number of young people in Virginia are choosing to reduce their consumption of sugar-sweetened beverages. We are proud of the progress we ve made. By promoting active, nutritious and tobacco-free living, the Virginia Foundation for Healthy Youth empowers Virginia s youth to make healthy choices. youth We must, however, remain vigilant. As new children reach the age of experimentation with smoking, the Virginia Foundation for Healthy Youth will continue to be there for them, keeping up with their ever-changing youth culture and helping them to grow into happy, healthy adults. learning commun move Thank you for your continued support of VFHY and Virginia s children. nature Sincerely, FUN Marty H. Kilgore Executive Director Virginia Foundation for Healthy Youth EXPLORE 3 Virginia Foundation for Healthy Youth o-free happiness laugh

4 Background deaths About VFHY The Virginia Foundation for Healthy Youth (VFHY) empowers Virginia s youth to make healthy choices by promoting active, nutritious and tobacco-free living. In 1999, as a result of the Master Settlement Agreement (MSA), the Virginia General Assembly established VFHY to lead youth tobacco-use prevention efforts in Virginia. In 2009, due to our great success at reducing youth tobacco use, the General Assembly expanded our mission to include childhood obesity prevention. VFHY receives no taxpayer funds. Our budget comes from a small percentage of Virginia s annual Master Settlement Agreement (MSA) payments. DID YOU KNOW? Tobacco use and obesity are the two leading causes of preventable in the United States. We Get Results Since we began working with young people in 2001, the number of high school students who smoke in Virginia has been cut by more than 60 percent and the number of middle schools students who smoke has dropped by more than 75 percent! Members of our Y Street high school volunteer group logged 6,000 volunteer hours on projects in FY VFHY also funded 20 Healthy Communities Action Teams (HCATs) to prevent and reduce childhood obesity across Virginia in FY2015. These collaborative groups instituted a variety of projects ranging from running farmers markets and building community playgrounds to offering youth nutrition classes and increasing opportunities for physical activity in localities statewide. Master Settlement Agreement In 1998, the Attorneys General of 46 states, including Virginia, signed the MSA with the nation s four largest tobacco manufacturers to settle state lawsuits to recover costs associated with treating smoking-related illnesses. The spirit and intent of the MSA was to provide states with funding for tobacco-use prevention efforts that would ultimately lower the prevalence of tobacco use, thus also lowering long-term medical costs. VFHY s Goals Include: Leading youth tobacco-use and childhood obesity prevention efforts in the Commonwealth by building partnerships and collaborations Empowering young people to make healthy choices, such as living smoke-free, being physically fit and eating nutritious foods Promoting school- and community-based initiatives that target youth tobacco-use and childhood obesity prevention and reduction Developing marketing strategies, including prevention messaging and youth volunteerism, to promote VFHY s goals of reducing and preventing youth tobacco use and childhood obesity Funding collaborative research projects related to youth tobacco-use prevention and studying factors that impact youth tobacco use. VFHY STAFF CENTRAL OFFICE STAFF 701 East Franklin Street Suite 500 Richmond, Virginia Marty Kilgore Executive Director Margaret White Deputy Director Eloise Burke Senior Executive Assistant Richard Foster Public Affairs Manager Donna Gassie Director of Programs Henry Harper Director of Community Outreach and Development Heidi Hertz Childhood Obesity Prevention Coordinator Wilma Jordan Business Manager Charlie McLaughlin Jr. Training and Resource Manager Danny Saggese Director of Marketing REGIONAL STAFF NORTH REGION Lisa Brown Regional Grants Administrator 2465 Centreville Road #J Herndon, VA CENTRAL REGION Terri-ann Brown Regional Grants Administrator 701 E. Franklin St., Suite 500 Richmond, VA SOUTHEAST REGION Judy Link Regional Grants Administrator 2926 George Washington Memorial Highway Hayes, VA SOUTHWEST REGION Jenny Martin Regional Grants Administrator 1700 Kraft Drive Suite 2416 Blacksburg, VA Virginia Foundation for Healthy Youth

5 Board of Trustees CHAIR The Honorable John H. O Bannon III, M.D., member, House of Delegates, representing the 73rd District (concurrent with House term) VICE CHAIR Sandy L. Chung, M.D., of Sterling, physician, Fairfax Pediatric Associates, PC (term expires June 30, 2019) MEMBERS Laura E. Beamer, of Richmond, Youth Member (term expires June 30, 2017) Valerie L. Bowman, M.D., FAAP, of Richmond, pediatrician, Developmental Assessment Clinic, Bon Secours St. Mary s Hospital (term expires June 30, 2018) January Britt, of Henrico, teacher (term expires June 30, 2017) Edda Collins Coleman, of Springfield, vice president, Hill+Knowlton Strategies (term expired June 30, 2015) Stacey Ely, of Abingdon, community and government relations director, Mountain State Health Alliance (term expired June 30, 2015) The Honorable T. Scott Garrett, M.D., member, House of Delegates, representing the 23rd District (concurrent with House term) The Honorable Thomas A. Garrett Jr., member, Senate of Virginia, representing the 22nd District (concurrent with Senate term) Glory Gill, of Hampton, member, Virginia School Nurses Association (term expires June 30, 2018) Sarah Bedard Holland, of Richmond, executive director, Virginia Oral Health Coalition (term expires June 30, 2018) Jimmy Jankowski, of Richmond, Youth Member (term expires June 30, 2017) Ritsu Kuno, M.D., of Richmond, pulmonologist, Pulmonary Associates of Richmond (term expires June 30, 2018) Marissa J. Levine, M.D., commissioner of health, Virginia Department of Health (concurrent with appointment) Robert Leek, of Williamsburg, senior physician liaison, Sentara Healthcare (term expires June 30, 2018) Sarah T. Melton, PharmD., BCCP, CGP, of Lebanon, director of addiction outreach and associate professor of pharmacy practice, Appalachian College of Pharmacy (term expires June 30, 2018) The Honorable John Miller, Newport News State Senator representing the 1st District (concurrent with Senate term) Jeffrey L. Painter, of Richmond, chairman, Virginia Department of Alcoholic Beverage Control (concurrent with appointment) Kristina Powell, M.D., of Williamsburg, pediatrician, Pediatric Associates of Williamsburg (term expires June 30, 2017) Davis Rennolds, of Richmond, consultant, McGuireWoods; state director, Share Our Strength (term expired June 30, 2015) Vineeta Shah, MHS, R.D., of Richmond, independent consultant, Anna Julia Cooper Episcopal School and Virginia Commonwealth University (term expires June 30, 2018) India Sisler, M.D., of Richmond, interim chief and assistant professor, Division of Hematology and Oncology, Department of Pediatrics, Virginia Commonwealth University (term expires June 30, 2018) Board Service: July 1, June 30, Virginia Foundation for Healthy Youth

6 Virginia Youth Survey The Virginia Foundation for Healthy Youth and the Virginia Department of Health (VDH) conduct biennial surveys of youth health behaviors, including tobacco use, nutrition and physical activity. These results are reported to the Centers for Disease Control and Prevention (CDC). VFHY prevention class (Floyd County) The Virginia Youth Survey (VYS) has been developed to monitor priority health risk behaviors that contribute markedly to the leading causes of death, disability and social problems among youth and adults within the commonwealth of Virginia. VDH in collaboration with VFHY and the Virginia Department of Education administered the most recent Virginia Youth Survey in fall The survey was administered to students in grades 6-12 in randomly selected middle and high schools statewide. The survey questions were tested and validated by the Centers for Disease Control and Prevention. Questions asked on the Virginia survey are directly comparable to the standardized questions asked in other states. youth Figure 1. Percentage of Middle School and High School Students in Virginia 35 who Currently Smoke: 2001 to 2013 Middle school High school 30 learning community 25 move 20 nature FUN Year Source: Virginia Department of Health and Virginia Foundation for Healthy Youth Virginia Youth Survey, 2013 EXPLORE 6 Virginia Foundation for Healthy Youth Percentage (%) co-free happiness laugh

7 VFHY at a Glance We Get Results MIDDLE SCHOOL SMOKING RATE HAS DECLINED 10.6 % HIGH SCHOOL SMOKING RATE HAS DECLINED 28.6 % 11.1 % 2.5 % KIDS PREVENTED FROM SMOKING 97,000 EACH YEAR LIVES VFHY WILL SAVE 31,000 EACH YEAR IN DECADES TO COME SAVINGS TO STATE GOVERNMENT $1.69 BILLION KIDS REACHED 697,000 EACH YEAR OVERWEIGHT TEENS DECREASED FROM 17.2 % IN 2011 TO 14.7 % IN 2013 TEENS NOT DRINKING SODA FROM 20.6 % IN 2011 TO 27.1 % IN 2013 We Have More Work to Do 7,300 KIDS UNDER AGE 18 ARE BECOMING SMOKERS EACH YEAR 110,878 OBESE AND OVERWEIGHT HIGH SCHOOL STUDENTS TAXPAYERS PAY $3.11 BILLION IN SMOKING-RELATED HEALTH CARE COSTS 5,000 YOUTH DIAGNOSED WITH TYPE II DIABETES EACH YEAR NATIONALLY 7 Virginia Foundation for Healthy Youth

8 Weight of the State Conference Marion Nestle, the Paulette Goddard Professor at New York University s Department of Nutrition, Food Studies, and Public Health, delivered the keynote address at VFHY s fourth Weight of the State childhood obesity prevention conference, which was held in April 2015 in Richmond. Nestle s award-winning books include Food Politics: How the Food Industry Influences Nutrition and Health. Hundreds of prevention, education, health and medical professionals from across the Commonwealth attended the conference, which showcased the latest approaches in childhood obesity prevention and control. National, state and local presenters shared cutting-edge tactics for reducing and preventing obesity, including community-based approaches and policy changes. Also during the conference VFHY released the results of a new survey examining Virginians access to fresh fruit and vegetables. The survey was conducted by VFHY s nationally recognized volunteer group for high school students, Y Street, as part of its Fresh Spot campaign to increase the availability of fresh and healthy foods to all Virginians. Survey respondents indicated that 28 percent of Virginians have difficulty finding fresh fruits and vegetables to purchase in their communities. More than 2,700 Fresh Spot surveys were collected in 169 Virginia communities between November 2014 and March 2015 by youth members of Y Street. The Fresh Spot survey also examines Virginians demand for fresh and healthy food. In today s busy times, eating healthy can be a challenge, says Virginia Foundation for Healthy Youth Director of Marketing Danny Saggese. Many communities in Virginia have only one major supermarket or large grocery store, making it difficult to find fast and convenient healthy food options. The Fresh Spot campaign unites Virginians across the state in asking stores to make healthy shopping easier for themselves and their families. Currently, two-thirds of Virginian shoppers say they want to improve their health, but only half of shoppers feel their local grocery stores help them make healthy choices. 8 Virginia Foundation for Healthy Youth

9 CHILDHOOD OBESITY PREVENTION First Lady of Virginia Dorothy McAuliffe participated in a Farm to School kickoff event held at J. Blaine Blayton Elementary School in Williamsburg in October VFHY helped coordinate the event with the Virginia Department of Agriculture and Consumer Services, Williamsburg- James City County Public Schools and the Virginia School Nutrition Association. 2015

10 Childhood Obesity Prevention The Virginia Foundation for Healthy Youth s obesity prevention efforts emphasize policy and environmental strategies to make healthy eating and active living accessible for everyone. Through our work, VFHY is playing a leading role in creating communities that support healthy kids and healthy living. Since expanding the agency s mission to include childhood obesity prevention, VFHY has served as a catalyst for partnership and collaboration, focusing on local, regional and state organizations with a commitment to reduce and prevent childhood obesity. Through our Healthy Communities Action Teams (HCATs), VFHY has invested in community-led obesity prevention activities by using a team-based approach and promoting evidence-based practices from the Institute of Medicine. HCATs serve as coordinators and conveners for local activities and build momentum around increasing access to healthy foods, promoting physical activity and preventing childhood obesity. Stories from VFHY s HCATs demonstrate that creating healthier environments leads to healthier behaviors. For example, VFHY-funded HCATs working to improve the built environment have demonstrated that students are more active when there are safe streets, sidewalks and crosswalks to walk or bike to school. VFHY utilizes innovative approaches to address childhood obesity by creating statewide campaigns to increase awareness and promote healthy eating and physical activity. VFHY celebrates Healthy Youth Day each January to promote increased physical activity, better nutrition and tobacco-free living for children. To increase awareness on the health impacts of sugar sweetened beverages, VFHY and partners throughout the state celebrate Rev Your Bev Day in May. Also in May VFHY promotes Screen-Free Week, encouraging youth and families to get unplugged from televisions, computers and electronic devices and find fun ways to be physically active. And to focus attention on the issue of childhood obesity VFHY recognizes Childhood Obesity Awareness month each September. During the month VFHY highlights grantee success stories and this year provided a toolkit for schools and communities to use as a resource for their own Childhood Obesity Awareness Month celebrations. How can we expect Virginia s children to be hungry to learn when they are just plain hungry? First Lady of Virginia Dorothy McAuliffe Healthy Starts with Early Childhood With more than one in five children ages 2 to 5 years old already overweight or obese, prevention efforts must target our youngest children. Since most young children spend time in care outside of their home, VFHY is partnering with leaders in early childhood to reach children in preschool classrooms and childcare centers. Improving the early childhood education environment directly impacts children s nutrition and physical activity, as well as helping them develop healthy habits for life. This year VFHY tailored two of its campaigns, Rev Your Bev and Screen Free Week, to early childhood education audiences. In May 2015 more than 100 early childhood education providers across the state celebrated Rev Your Bev Day with customized resources for preschoolers. Early childhood educators led lessons about choosing healthy beverages, read stories about the importance of drinking water and changed their classroom environments by providing fresh water instead of sugary drinks at snack times. To encourage reduced screen time among preschoolers, VFHY released a Screen Free Toolkit for early childhood educators to use to keep children active and to help teachers talk to preschoolers about the dangers of too much screen time from televisions, computers and video games. 10 Virginia Foundation for Healthy Youth

11 Childhood Obesity Prevention Making connections between hunger and obesity To address hunger and obesity in Virginia, the Virginia Foundation for Healthy Youth has developed new partnerships and explored innovative strategies to find a common solution to both of these issues. Hunger and obesity are serious public health problems and often can co-exist in the same individual, family or community. More than 311,410 children in Virginia face food insecurity, living in homes with limited access to a dependable food supply. Hungry children are more frequently sick, more likely to be hospitalized and can experience more behavioral and social problems. Perpetuated by limited access to healthy and affordable foods, food-insecure children are at a greater risk of becoming overweight or obese as compared to their more affluent peers. In our state more than 26 percent of high school students and 30 percent of middle school students are overweight or obese. Bridging the Nutritional Divide On Nov. 20, 2014, Virginia Gov. Terry McAuliffe signed into effect Executive Order No. 34, creating the Commonwealth Council on Bridging the Nutritional Divide. Chaired by First Lady of Virginia Dorothy McAuliffe, this initiative aims to bridge the nutritional gap in Virginia through key objectives that strive to eliminate childhood hunger. Serving as a member of the council, VFHY is working to support local initiatives across the Commonwealth by enhancing communication, coordinating local efforts and convening partners. Great Starts with Breakfast Children in Virginia are not hungry because of a lack of federal child nutrition programs; rather, food insecurity is bolstered by an underutilization of these programs by those eligible. The school breakfast program is one of the most underutilized child nutrition programs, yet eating breakfast is essential for success in the classroom. In Virginia, just 51.3 percent of students receiving free and reduced price lunch also participate in the free- and reduced-price school breakfast program. Rev Your Bev Day 2015 On May 13, 2015, students, teachers, youth activists, community organizations and health advocates statewide posed a simple question to more than 60,000 Virginians across the state: Do you know what s hidden in your drink? This question was answered at more than 300 events held across Virginia in celebration of the third annual Rev Your Bev Day part of VFHY s initiative to raise awareness about the contents of sugary drinks. Data collected from Rev Your Bev Day since 2013 has revealed that one in three Virginians, both youth and adults, drink at least one sugar-sweetened beverage each day, says Virginia Foundation for Healthy Youth Obesity Prevention Coordinator Heidi Hertz. This underscores the need for continued education on sugary drinks and alternative healthy options. Schools, organizations and businesses participating in Rev Your Bev Day also assisted in a statewide data collection project being conducted by Y Street, the Virginia Foundation for Healthy Youth s award-winning teen volunteer group for high school students. Sugary drinks remain the top source of sugar and calories in Americans diets, despite the health impacts; for every additional sugar-sweetened beverage consumed per day, a child s risk of becoming overweight increases by 60 percent. In order to support efforts to decrease hunger among Virginia school children VFHY and our Y Street high school volunteer group have partnered with the Office of the First Lady to create the Great Starts with Breakfast initiative. This effort aims to expand availability, accessibility and participation in the school breakfast program. Findings from statewide surveys revealed that being pressed for time is a primary reason cited when students are asked why they don t eat school breakfast and that students would be more likely to eat school breakfast if alternative breakfast models such as breakfast after the bell or grab-and-go breakfast options were available. 11 Virginia Foundation for Healthy Youth

12 Childhood Obesity Prevention Virginia Healthy Youth Day About 450 Richmond-area school children attended VFHY s sixth annual Virginia Healthy Youth Day celebration, which was held on Jan. 20, 2015, on the State Capitol lawn. First Lady of Virginia Dorothy McAuliffe served as keynote speaker. Students from Chesterfield County middle schools participated in the event, which included exercise sessions with fitness specialists from the YMCA of Greater Richmond and fun smoking prevention lessons from Mad Science of Central Virginia. Other dignitaries in attendance included Virginia Secretary of Health and Human Resources Dr. Bill Hazel. Established by a Virginia General Assembly resolution, Virginia Healthy Youth Day is held every January by VFHY and promotes physical fitness, good nutrition and healthy lifestyles for Virginia s children. Virginia Healthy Youth Day reminds us that being physically active should be a yearround goal for Virginia s young people and not limited to just warm summer days, says VFHY Executive Director Marty Kilgore. Virginia Healthy Youth Day reminds us that being physically active should be a year-round goal for Virginia s young people and not limited to just warm summer days. Marty Kilgore, VFHY Executive Director 12 Virginia Foundation for Healthy Youth

13 Childhood Obesity Prevention VFHY HEALTHY COMMUNITIES ACTION TEAM GRANTSR TOTAL GRANT FY 2015 REGION GRANTEE AWARD PORTION CENTRAL Greater Richmond Fit4Kids $62,800 $35,095 Page County Public Schools - Page Alliance for Healthy Community Action $39,000 $20,565 Project GROWS $63,000 $36,150 City of Richmond Department of Social Services - Richmond Health Action Alliance $63,000 $35,050 Rockbridge Community Services - Rockbridge Area Healthy Community Action Team $62,584 $35,542 Rockingham Memorial Hospital - Healthy Community Council Obesity Action Team $63,000 $34,984 NORTH Arlington County Parks and Recreation $29,286 $22,243 City of Alexandria $62,718 $34,062 Stafford Junction $60,960 $32,792 Warren Coalition $63,000 $36,000 SOUTHEAST Eastern Virginia Medical School- Eastern Shore $36,000 $36,000 Eastern Virginia Medical School -Hampton Roads $36,000 $36,000 Halifax United Way $36,000 $36,000 Middle Peninsula-Northern Neck Community Services Board $36,000 $36,000 Suffolk Partnership for a Healthy Community $36,000 $36,000 SOUTHWEST Carilion Medical Center $60,700 $35,134 LENOWISCO Health District $60,437 $33,915 Martinsville Henry County Coalition for Health and Wellness $60,210 $32,815 New River Valley Community Services $62,996 $33,764 United Way Virginia Highlands $61,335 $35, Virginia Foundation for Healthy Youth

14 PROGRAMS Children get a look at the thick, sticky black tar that smoking leaves behind in the body during at a VFHY-funded LifeSkills after-school prevention program implemented by Loudoun County Community Services Board at Sugarland Elementary School in Sterling. 2015

15 Programs Since 2001 VFHY has reached more than 1 million children with classroom-based tobacco-use prevention and cessation programs in communities across Virginia. Taught at hundreds of public schools, community centers, faith centers, day cares and preschools statewide, VFHY s evidence-based educational programs provide direct interaction with children and teens and are a key element in changing youth attitudes and behaviors about tobacco use. energize smile During FY 2015 VFHY served more than 50,000 youth across Virginia through 55 tobacco-use prevention grant programs. Grant recipients included a variety of organizations teaching kids from preschool through high school. VFHY has awarded more than 1,000 such grants since we started our work in Program Evaluation VFHY conducts trainings, site visits and ongoing monitoring to evaluate its community-based grant programs throughout implementation to ensure that each program is being com pleted as designed. In addition, VFHY contracts with the Virginia Commonwealth University Institute for Drug and Alcohol Studies to conduct concept mapping evaluation of VFHY grant programs for both tobacco-use and obesity prevention. This innovative strategy for program evaluation collects data related to youth attention, engagement and participation in funded programs. Concept mapping also evaluates instructor experience, assists in identifying and reducing barriers to success and identifies strategies to increase the long-term sustainability of positive program outcomes beyond the initial years of the grants. FU ac IMA EXPLORE tobacco-free happin FRIENDS move learning na youth 15 Virginia Foundation for Healthy Youth c

16 Programs Compendium All of the funded grants used programs found in VFHY s Compendium of Tobacco- Use Prevention Programs for Youth. The compendium programs address issues relative to tobacco-use prevention, including primary tobacco-use prevention education, tobacco cessation, early tobacco intervention and reduction, youth empowerment and social-skills building. These evidence-based programs have been recognized by national, state and nonprofit organizations as model, promising or effective tobacco-use prevention programs. VFHY provides extensive training and technical assistance to help facilitators more effectively reach young people through our compendium programs. VFHY Compendium of Programs All Stars Al s Pals ATHENA (Athletes Targeting Healthy Exercise & Nutrition Alternatives) Botvin LifeSkills Training Creating Lasting Family Connections Helping Teens Stop Using Tobacco (TAP) Intervening with Teen Tobacco Users (TEG) Know Your Body Media Detective Media Ready Minnesota Smoking Prevention Program Not On Tobacco Positive Action Project Alert Project EX Project Toward No Drug Use (TND) Project Toward No Tobacco Use (TNT) Strengthening Families (ages 6-11) Strengthening Families (ages 10-14) Too Good for Drugs 16 Virginia Foundation for Healthy Youth

17 Programs VFHY TOBACCO-USE PREVENTION & CESSATION PROGRAMS THREE-YEAR GRANTS FY 2015 TOTAL GRANT REGION GRANTEE COMPENDIUM PROGRAM AMOUNT AMOUNT CENTRAL Central Shenandoah Valley Office on Youth Positive Action $60,000 $180,000 Chesterfield County Public Schools Botvin LifeSkills Training $60,000 $180,000 Hanover Community Services Board Positive Action $51,576 $151,069 Horizon Behavioral Health Too Good For Drugs $47,029 $159,356 HumanKind Botvin LifeSkills Training $56,937 $171,385 Medical Home Plus Al s Pals $59,987 $179,961 Orange County Office on Youth Strengthening Families $59,772 $177,749 Page County Public Scools All Stars $7,702 $40,265 ReadyKids Al s Pals $52,900 $158,872 Richmond City Health District Positive Action $28,032 $98,114 Rockbridge Area Community Services Board Too Good For Drugs $59,801 $179,602 Rockingham Memorial Hospital Project TNT $59,385 $178,770 Skyline CAP Al s Pals $32,106 $101,655 Southside Area Rural Health Education Center Al s Pals $27,924 $87,596 Virginia Rural Health Resouce Center Too Good For Drugs $32,295 $96,990 YMCA of Richmond Al s Pals $15,319 $91,904 NORTH Alexandria Community Services Board Al s Pals $59,735 $175,729 Arlington County Community Services Board Strengthening Families $58,907 $175,413 Boys & Girls Club of Northern Shenandoah Valley Positive Action $16,942 $52,744 Boys & Girls Clubs of Greater Washington Botvin LifeSkills Training $37,896 $120,288 Ethiopian Community Development Council Botvin LifeSkills Training $44,927 $131,740 Fairfax County Neighborhood & Community Services Project TNT and TND $60,000 $180,000 Fairfax/Falls Church Community Services Board Al s Pals $60,000 $180,000 Fauquier CADRE Too Good for Drugs $58,280 $175,266 Global Wellness Solutions Too Good For Drugs, Botvin LifeSkills Training $61,992 $179,651 Loudoun County Mental Health Botvin LifeSkills Training $57,037 $167,456 Manassas City Public Schools Botvin LifeSkills Training $22,468 $68,447 Smart Beginnings Rappahannock Al s Pals $59,832 $179,613 Warren Coalition Botvin LifeSkills Training, Not on Tobacco (NOT) $56,478 $172,149 Winchester Public Schools Too Good for Drugs $3,663 $14,276 Youth Apostles All Stars Core and Plus $38,065 $112, Virginia Foundation for Healthy Youth

18 Programs VFHY TOBACCO-USE PREVENTION & CESSATION PROGRAMS THREE-YEAR GRANTS FY 2015 TOTAL GRANT REGION GRANTEE COMPENDIUM PROGRAM AMOUNT AMOUNT SOUTHEAST Alternatives Al s Pals $59,886 $179,772 Boys & Girls Clubs of Southeast Virginia Positive Action $56,860 $170,405 Boys & Girls Clubs of Virginia Peninsula Positive Action $59,460 $178,664 Crossroads Community Services Board Too Good for Drugs $52,621 $178,664 C. Waldo Scott Center for H.O.P.E. Too Good for Drugs $23,395 $70,155 Eastern Shore Community Services Board Al s Pals $59,704 $179,260 Hampton Parks and Recreation Positive Action $42,691 $179,805 Hampton-Newport News Community Services Board Botvin LifeSkills Training $59,903 $139,573 Middle Peninsula-Northern Neck Community Services Board Botvin LifeSkills Training $59,944 $179,888 Peninsula Metropolitan YMCA Know Your Body $40,520 $120,993 Southside Area Rural Health Education Center Al s Pals/Botvin LifeSkills Training $59,904 $179,805 The UP Center Changing Lasting Family Connections $59,910 $179,820 Three Rivers Health District Too Good For Drugs $34,520 $104,441 William Hunton YMCA Positive Action $60,000 $180,000 YMCA South Hampton Roads Positive Action $49,223 $178,509 SOUTHWEST Blue Ridge Behavioral Healthcare Too Good for Drugs $42,901 $126,999 Galax City Schools Botvin LifeSkills Training, Youth Media Network $32,969 $95,310 Henry County Schools Too Good for Drugs $51,726 $152,408 Highlands Community Services Board Botvin LifeSkills Training $60,000 $180,000 Mount Rogers Community Services Board Botvin LifeSkills Training, Youth Media Network $39,071 $117,213 New River Valley Community Services Toward No Drug Use $59,993 $179,979 Piedmont Community Services Too Good for Drugs $60,000 $180,000 Planning District One Behavioral Health Services Toward No Tobacco Use $14,599 $42,201 Pulaski County Public Schools Too Good For Drugs, Project TND, $59,045 $178,225 Intervening with Teen Tobacco Users 18 Virginia Foundation for Healthy Youth

19 Programs CAPACITY BUILDING Each year VFHY offers capacity building and obesity and tobacco-use prevention program training for grantees and other organizations throughout Virginia. In FY 2015, in collaboration with the Department of Behavioral Health and Developmental Services (DBHDS) and the Virginia Department of Health (VDH), VFHY offered nearly 30 workshops. Through a small registration fee and scholarship funding provided by DBHDS and VDH, all trainings were self-funded. The following organizations and trainers were contracted to provide the listed workshops: TRAINER WORKSHOP(S) AMOUNT PAID Kim Brown Promoting Proven Practices and Processes for Sustainable Community-Level Outcomes $1,100 Kim Brown and Ginny Hardin Substance Abuse Prevention Skills Training (SAPST) $3,200 Keith Cartwright Lead & Seed Training $800 Janis Dauer Electronic Cigarettes: What We Know, What We Don t Know, What We Should Do $1,600 Alejandro Garcia-Barbon Effective Tobacco Use Prevention and Cessation Strategies for Youth and Young Adults $600 Ted Groves Using Virginia Kids Count Data to Determine the Well-Being of Children in Your Locale $500 Eletta Hansen Reducing Tobacco Use Among Pregnant Teens and Young Adult Women $1,100 Ginny Hardin and Valerie Liggins-Law Substance Abuse Prevention Skills Training (SAPST) $3,200 Steve Hixon The Culturally Competent Professional: Working With an Open Mind $500 Steve Hixon and Keith Cartwright Substance Abuse Prevention Skills Training (SAPST) $1,600 Leading to Change BOYS WILL BE BOYS: Reaching and Teaching Young Men $2,000 Generational XROADS: When X, Y and Boomers Collide Virtual Realities: Social Networking and Today s Youth Valerie Liggins-Law Grant-Writing: It s a Process and There are No Quick Fixes $600 Alayne MacArthur Spice Up Your Prevention Program: Teaching Strategies and Activities for Engagement $1,200 Engaging Students Who Don t Seem to Care Ways of Asking Jim Martin Planning and Implementing Evidence-Based Tobacco-Use Prevention Strategies $800 Cydny Neville Together We Move! Developing, Managing and Maintaining Effective Community Partnerships $600 Rachel Rose From Time-Out to Outstanding: How Dietary Changes can Improve Children s Overall Health $500 Freddie Simons and Keith Cartwright Substance Abuse Prevention Skills Training (SAPST) $1, Virginia Foundation for Healthy Youth

20 MARKETING Virginia Lt. Gov. Ralph Northam celebrates tobacco-free schools during the Virginia Beach kickoff of VFHY s statewide 24/7 Tobacco-Free Spirit Day on Nov. 18, 2015, with help from Y Street teen volunteers Brittany Williams and Daryl Anderson of Green Run High School. 2015

21 Marketing Approach The Virginia Foundation for Health Youth (VFHY) recognizes that not all youth are the same. Some youth will never use tobacco products regardless of VFHY s efforts. Others are very likely to use tobacco products unless someone intervenes. The latter are our target audience. Reaching these youth requires that we change their knowledge, environment and culture. VFHY s goals in each of these are: Knowledge Educate teens on the health, social and environmental consequences of tobacco use and encourage them to choose to live a tobacco-free lifestyle. Environment Encourage community stakeholders and institutions, such as parents, community leaders and schools to reject youth tobacco use, tobacco marketing to youth and tobacco sales to youth and create an environment that encourages tobacco-free lifestyle choices. PEER CROWD: Groups of youth who share a combination of fashion, music, language, culture, mannerisms, media consumption habits and other behaviors to define their social identity and differentiate themselves from other groups of youth. Culture Promote cultural change within the peer crowd of every Virginia teen to ensure that living tobacco-free is perceived as a socially desirable choice. Rather than try to address all three of these domains through a single approach, VFHY recognizes that knowledge, environment and culture are three uniquely important domains for change that require unique strategies. Consequently, VFHY has worked with its social marketing and advertising contractors to identify three separate strategies for these domains as illustrated on the following pages: 21 Virginia Foundation for Healthy Youth

22 Marketing YOUTH ENGAGEMENT Some youth are proud to be tobacco-free and want to help make their world more tobacco-free. These leaders can contribute significantly to the health of Virginia s youth if their passion can be channeled towards tangible change. Through a hands-on, seven-year process of trying different models of youth engagement, VFHY discovered strategies to engage youth in projects and events that contribute to environmental change. This includes reaching parents, administrators, peers, community leaders and other stakeholders who have the power to change the environments where youth live and make them more conducive to tobacco-free lifestyles. Youth engagement for tobacco prevention is defined by the Centers for Disease Control and Prevention (CDC) as providing the opportunity for young people to gain the ability and authority to make decisions that help improve the policy environment, change social norms and reduce smoking initiation and consumption in their communities. In 2004 VFHY launched its youth volunteer program, Y Street, to engage youth in changing tobacco-use norms. Over the years, Y Street has evolved constantly to adopt the most cost-effective strategies that engage the largest numbers of youth. In addition, when the Virginia legislature asked VFHY to tackle childhood obesity prevention in 2009, Y Street was the first VFHY program to step up by expanding its scope to include both tobacco-use and childhood obesity prevention. (MOPs) are created for each campaign. MOPs are tangible outcomes that document incremental steps towards the campaign s goals, such as testimonials, surveys, message cards, etc. Then, youth volunteers develop events and projects that focus on the completion of these MOPs. Youth are empowered to produce any kind of project or event, allowing them to be creative while at the same time focusing all youth efforts on the overall campaign outcomes. In addition, MOPs help youth volunteers measure the impact of their projects, which keeps them motivated and encourages them to create more effective strategies. As MOPs build up, Y Street youth volunteers are able to advocate for policy changes, such as preventing tobacco products from being advertised to youth, etc. Through this process, Y Street youth have completed more than 75,000 MOPs, leading to results such as reports on Virginians opinions of clean indoor air, or Virginians consumption of sugar-sweetened beverages. Y Street youth volunteers have even been invited to testify before the FDA, present findings at national conferences, and participate in press conferences with the Governor of Virginia and the U.S. Surgeon General. Today, Y Street is one of the nation s largest and most efficient youth engagement programs, each year training more than 600 new high school students. Combined with youth trained in prior years, more than 8,000 youth have been trained, and they volunteer more than 6,000 hours annually. The Y Street model simplifies how youth are engaged in changing their environment. First, campaigns are created that focus on clear, short-term goals, such as educating community members about the dangers of flavored tobacco products or the benefits of physical education in public schools. Next, Measures of Progress 22 Virginia Foundation for Healthy Youth

23 MARKETING SPOTLIGHT Y STREET Since 2004 VFHY s youth engagement program, Y Street, has trained more than 8,000 youth to be agents of change in their communities. Each year a dedicated group of these youth, called Y-Sters, become members of the Y Street Leadership Team (YSLT). Joshua Pritchett is one of the YSLT leaders who work towards Y Street s goal of creating a healthier Virginia. Joshua joined Y Street as a sophomore from Chesapeake who wanted to make a difference. I became a part of Y Street to better help my family, but it branched out to where I was helping to inspire my peers as well, he says. Joshua not only inspired his peers, but his reach extended both into the community and on a national scale when the Campaign for Tobacco-Free Kids named him its 2015 Youth Advocate of the Year for the Eastern Region of the United States. Volunteering for Y Street, Joshua was especially passionate about his work on the 24/7 campaign, which helps school systems become tobacco-free 24 hours a day, seven days a week. Joshua spoke with parents, teachers and members of the community about the importance of tobacco-free schools, collected surveys to gauge the community s understanding of his school division s tobacco-free policy and met with school officials including his local school board to offer Y Street s help in providing 100 percent comprehensive tobacco-free school resources. These resources included free tobacco-free signs as well as a free toolkit to help schools implement, communicate and enforce their own 100 percent comprehensive tobacco-free school policy. Youth should be the group to take control and try to make change, Joshua says. If youth are making change, then that will inspire future generations. Being part of your community is its own reward. Y Street puts forth that effort to ensure a healthier Virginia, especially for its youth. Youth should be the group to take control and try to make change. Joshua Pritchett, Y Street Leadership Team member 23 Virginia Foundation for Healthy Youth

24 Marketing CULTURE CHANGE Adults often cite peer pressure as the reason youth begin to smoke. But in reality, the reasons are more complicated than that. Few youth experience an isolated incident where one youth pressures him or her to smoke a cigarette. Instead, youth are more likely to experience an internalized pressure to use tobacco products from their peer crowd as a whole. When they believe smoking is the norm in their culture, they begin to feel the pressure to adopt the behavior. But peer crowds aren t all bad; some promote tobacco-free norms. Consequently, VFHY has focused on identifying the peer crowds that are associated with tobacco use and then uses Social Branding strategies to change the norms within those peer crowds to promote tobacco-free lifestyles. Making tobacco use uncool eliminates a young person's desire to use tobacco products. But that s easier said than done. Changing cultural norms among young people requires penetrating their peer crowd in an authentic manner. To do this, VFHY first has to identify and understand the most common peer crowds in Virginia and determine which of these niche youth cultures are most likely to use tobacco products. With the help of its contractors Rescue Social Change Group and Market Decisions Health Care Research, VFHY has collected ongoing data on the most common peer crowds in Virginia. Five peer crowds are present in nearly every high school and each has a different tobacco-use rate. Changing the norms within each of these peer crowds requires strategies that are tailored to the unique images, language and media that define their culture. Using Rescue Social Change Group s Social Branding model, VFHY reaches these highrisk teens in their own social venues in order to associate being tobacco-free with the situations where tobacco use is most likely to occur. In addition, Social Branding campaigns recruit influencers from each peer crowd and train them on tobacco control facts and messages, creating change agents within each high-risk culture. VFHY began this strategy with the Alternative and Country/Rural peer crowds, which exhibit higher smoking rates than some other peer crowds. The SYKE and Down & Dirty campaigns target the Alternative and Country/Rural peer crowds, respectively, by hosting youth events, conducting social media campaigns, sending direct mail and training influencers. Recently the Fresh Society campaign was created to reach the Hip Hop peer crowd, another influential, at-risk group in Virginia. Collectively, these strategies strive to create change from within each peer crowd, reducing the pressure for current and future teens within those peer crowds to use tobacco products. 24 Virginia Foundation for Healthy Youth

25 Marketing KNOWLEDGE/MASS MEDIA No other strategy reaches as many people as comprehensively as mass media advertising. Through TV, radio, outdoor and social media, VFHY reaches youth in every corner of the state. In addition, advertising campaigns have been proven by the Centers for Disease Control and Prevention (CDC) to reduce youth tobacco use. Consequently VFHY uses a mass media advertising approach to spread knowledge to young people statewide. VFHY s award-winning advertising campaigns prioritize messages and media channels that evidence shows are most likely to reach at-risk teens. To select messages, VFHY first identifies which new piece of knowledge has the potential to change behavior. Then, creative ideas are developed to present the selected message in the most effective manner possible. VFHY repeats this process every six to eight weeks by creating a new campaign with new advertisements to ensure that messages are refreshed often, constantly piquing the interest of high-risk teens. In addition to mass media, each campaign is also promoted through Facebook, YouTube, Twitter and Instagram. These social media channels have proven to be the most popular among Virginia teens, allowing VFHY to communicate directly with teens. During each campaign VFHY has interactions with hundreds of teens through comments and direct messages. Each conversation deepens the brand s message and allows VFHY to interact with even the most skeptical high-risk youth. 25 Virginia Foundation for Healthy Youth

26 Marketing RESEARCH AND EVALUATION Ensuring VFHY s marketing efforts are effective is just as important as implementing them over time. VFHY develops and improves these strategies using comprehensive research with current and likely tobacco users. Then VFHY tracks and evaluates each effort through a comprehensive evaluation model that monitors statewide youth tobacco use. Rescue Social Change Group ($1,338,325) A VFHY contractor since 2004, Rescue Social Change Group is a social marketing agency focused exclusively on behavior change programs. Rescue SCG developed the Social Branding and Outcome Oriented Youth Engagement models utilized by VFHY and manages their implementation through the Y Street, Syke, Down & Dirty and Fresh Society programs. Learn more at rescuescg.com. The original ydouthink advertising campaign was based on the most extensive youth marketing research ever conducted in Virginia. VFHY continues to study and survey tobacco-related attitudes among Virginia middle and high school students, aiding us to further understand the associations between identity and tobacco use for individuals in the different peer crowds of youth existing in Virginia. CONTRACTORS VFHY currently works with numerous contractors for its marketing campaign, with the following FY 15 expenditures: Market Decisions Research ($13,400) Market Decisions Research was founded in 1977 and has served clients in 25 states. They conduct large-scale telephone surveys, mail/paper surveys, online surveys and focus groups for health care providers and government. MDR has been active in tobacco cessation and prevention evaluation since 2001 and has conducted both telephone and in-school paper surveys on tobacco-use prevalence and obesity for VFHY since Learn more at marketdecisions.com. Barber Martin Advertising ($1,587,491) Barber Martin Agency, one of the most stable and well-respected advertising agencies in Virginia, has served as the VFHY s creative and media strategy partner for several years. Founded in 1988, the agency was built almost exclusively with retail clients, which provides great experience, because in retail, results are everything. Barber Martin s track record of achieving results is part and parcel of its core competencies strategic brand development, digital integration, print, television, radio, media planning and placement, out-of-home, new media and social media. Learn more at BarberMartin.com. Virginia Broadcast Solutions Virginia Broadcast Solutions (VBS) is a unique Media Buying Service offered by the Virginia Association of Broadcasters. VBS works only with nonprofit organizations and Virginia government agencies on the development and implementation of powerful, effective and cost efficient media outreach programs. In addition to the strong relationships we have with 250 member broadcast radio and television stations, VBS also regularly works with a large number of media companies that include other types of traditional and new online digital/social media. MEE Productions ($29,900) Founded in 1990, MEE is a nationally-recognized public health communications, market research and social marketing firm that specializes in developing cost-effective, cutting-edge and culturally relevant messages for hard-to-reach, low-income and underserved audiences. MEE designs effective behavioral-health interventions to motivate and educate underserved communities around a number of public health and social issues. move EXPLORE learning co-free youth community nature FUN happiness 26 Virginia Foundation for Healthy Youth laugh

27 RESEARCH Tory Spindle, a doctoral student at Virginia Commonwealth University s Center for the Study of Tobacco Products, discusses a poster presentation during the Virginia Youth Tobacco Project s 2015 triennial research conference, funded by VFHY. 2015

28 Research What Social and Molecular Factors Drive Nicotine Preference in Adolescent Mice? Grant Award Amount (FY15): $118,131 Principal Investigator: Karl Fryxell, Ph.D., School of Systems Biology Collaborating Partner: Virginia Commonwealth University Researchers at GMU are investigating the relationship between stress, social isolation and adolescent nicotine use. In addition to behavioral assays, their research focuses on the D2 dopamine receptor, which plays key roles in all drugs of abuse and which they have previously shown has an adolescent-specific response to nicotine exposure. The researchers are also investigating the adolescent functions of the Cd81 gene, which they have previously shown is able to limit voluntary nicotine consumption and stress reactivity in adult mice. Behavioral tests of nicotine preference The research team has purchased and set-up a Coulbourn automated system for measuring nicotine consumption in two-bottle tests. This required some modifications to ensure that the water spouts were low enough to be easily accessible to adolescent mice. To ensure that the drinkometers would not be aversive to adolescent mice, the researchers wound up using an optical rather than electrical detection. They have also written and tested computer software to record and analyze the results. It ultimately proved to be necessary to transfer the mouse colony and experimental apparatus to the Krasnow Institute (a separate building on the GMU Fairfax campus), and to revise our IACUC protocol (which is in progress). mrna assays of D2 gene expression in adolescent mice The assays of D2 mrna levels in male adolescent mice showed that their responses to the first dose of nicotine differed significantly between right vs. left prefrontal cortex. The researchers have now analyzed mrna levels in additional brain areas of both male and female adolescent mice. The results showed that the mrna levels of both D2L and D2S isoforms were higher on the right sides of the brain areas assayed (medial prefrontal cortex, ventral striatum, and ventral tegmentum) in both adolescent male and adolescent female mice. There were significant sex differences in lateralization, with greater lateralization in saline controls among the females, and greater lateralization in the gene expression responses to nicotine among the males. Taken together, the results show that the mesolimbic dopamine system is lateralized, and suggest that this lateralization may play a role in the initiation of nicotine dependence in adolescents. Researchers also note that the acquisition of morphine dependence is also lateralized (Glick et al., 1992). Protein assays of D2 gene expression in adolescent mice The researchers at GMU have completed the nicotine dosing, sacrifice, dissection, and protein extractions for these experiments. Control experiments showed insufficient sensitivity on nitrocellulose membranes with an HRP (diaminobenzidine) label, and so they have shifted to PVDF membranes with a chemiluminescent (alkaline phosphatase) label. This required purchasing and setting up a new cooled CCD camera, and trouble-shooting its software. They also purchased a portable darkroom for this camera, then had to trouble-shoot multiple light leaks into this enclosure. The researchers also found that nonfat dry milk, which is used by most labs as a carrier protein in these experiments, interferes with our secondary antibody (donkey antigoat IgG), presumably due to the presence of traces of bovine IgG in the dry milk. Therefore they have switched to gelatin (from fish skin) as a source of carrier protein that does not contain any mammalian herbivore IgGs. Although these methods development steps have taken longer than anticipated, the GMU researchers are excited about the prospects for quantifying how nicotine stimulates the turnover of D2 dopamine receptors in adolescent mice. Virginia Youth Tobacco Projects Research Coalition Core Grant Award Amount (FY15): $149,989 Principal Investigators: Robert L. Balster, Ph.D., Alison Breland, Ph.D., J. Randy Koch, Ph.D., Institute for Drug and Alcohol Studies Collaborating Partners: Virginia Youth Tobacco Projects Research Coalition The College of William & Mary, George Mason University, Virginia Tech, James Madison University, University of Virginia, Old Dominion University, Virginia State University, and Virginia Commonwealth University With funding from the Virginia Foundation for Healthy Youth (VFHY), the Virginia Youth Tobacco Projects (VYTP) Research Coalition was established in 2002 to advance the prevention of youth tobacco use through an integrated program of basic 28 Virginia Foundation for Healthy Youth

29 Research and applied research, research translation and dissemination. The VYTP Research Coalition was funded for an additional three years (under the title of the VYTP Research Coalition Core) beginning July 1, 2012, to continue its successful efforts of the previous nine years. Major accomplishments for the past year include: The VYTP s fifth triennial conference on youth tobacco use. Titled The Future of Tobacco Control: Implications for the Prevention of Youth Tobacco Use in Virginia the conference was attended by 121 people representing universities, community-based prevention programs and government. Beginning with a welcome by Secretary of Health and Human Resources William A. Hazel Jr., the conference featured keynote and plenary panels on wide variety of topics of critical importance to the prevention of youth tobacco use, including the controversial topic of regulating electronic cigarettes, current initiatives of the FDA s Center for Tobacco Products, the Institute of Medicine s new report on raising the minimum age to purchase tobacco products and the use of technology in tobacco-use prevention programs. The annual meeting of the VYTP Research Coalition was held on Jan. 8, 2015, and featured presentations on the five VYTP-funded small research projects for the FY grant period. In addition, a workshop was conducted by Dr. Thomas R. Kirchner, New York University School of Public Health on Ecological Momentary Tobacco Control. EMTC is a new technology that uses real-time data collection to assess participants behaviors and environments to assess participant s tobacco use. The meeting ended with several brief presentations by graduate students and post-doctoral fellows as part of our effort to encourage the next generation of youth tobacco researchers. Overall, the VYTP Research Coalition has been extremely successful in building a strong program of research on the causes and prevention of youth tobacco use. It has facilitated the entry of both junior and senior researchers into this field of research and stimulated collaborations across institutional and disciplinary boundaries. Its success can also be seen by the tremendous productivity of its participating faculty, who in FY15 submitted more than 10 grant applications, published or submitted for publication more than 60 manuscripts and made more than 30 conference presentations on youth tobacco use. Exercise and Environmental Enrichment to Prevent Nicotine Addiction in Adolescent Males and Females Grant Award Amount (FY15): $149,997 Principal Investigators: Darlene H. Brunzell, Ph.D., Department of Pharmacology and Toxicology Co-Investigator: Wendy Lynch, University of Virginia Collaborating Partners: University of Virginia Cigarette smoking is the leading preventable cause of death in the United States, followed closely by obesity. Most smokers initiate tobacco use during adolescence or young adulthood. The researchers previous studies showed that only two hours of exercise available during a nicotine abstinence period significantly reduced relapse of male rats to nicotine-seeking when compared to rats that were sedentary during abstinence (Sanchez et al., 2013). They also found that female adolescent rats relapsed to nicotine seeking at equally low levels in the exercise and sedentary groups (Sanchez et al., 2014). To parse out the relative effect of exercise versus the effect of enriched environment, an extra group of animals was added that had no access to a wheel during the quit period. Females benefited from having a running wheel in their cage even if it was locked, suggesting that environmental enrichment, as well as exercise, reduces nicotine seeking in females. Interestingly, this is consistent with reports in teens which show that girls enrolled in an after-school program showed a significant improvement of smoking cessation independent of exercise, whereas boys only showed better quit rates if they were engaged in physical activity. The studies in rodents suggest that there is an underlying biological mechanism which dictates the benefits of exercise on potential to quit. The researchers have found that nicotine and exercise have similar effects on brain signaling, suggesting that exercise may act as a healthy substitute to smoking or vaping. As the best prognosis for tobacco cessation is to never begin smoking, a primary goal of these studies was to determine if exercise and/or environmental enrichment would prevent initiation of nicotine use in adolescent male and female rats. Adolescent rats were given two-hour access to a running wheel (exercise group) or a locked wheel (sedentary group) prior to daily nicotine self-administration, an animal model with good predictive validity for smoking. The findings were striking in that none of the animals that exercised initiated nicotine self-administration while 75% of the sedentary group 29 Virginia Foundation for Healthy Youth

30 Research initiated by the end of the 15-day testing period. These results indicate that exercise is a far more effective prevention method than could have been predicted. These preclinical studies suggest that physical exercise may have an unexpected benefit to prevent initiation of tobacco use in teens. The researchers examined the potential mechanisms for the efficacy of exercise at reducing nicotine-seeking focusing on its effects on structural plasticity in the reward pathway. Electron microscopy histological examination of synapses revealed a positive association between levels of nicotine-seeking and volumetric density of asymmetric synapses onto dendrites in nucleus accumbens core region. Interestingly, exercise during abstinence not only attenuated subsequent nicotine-seeking but also normalized the volumetric density of asymmetric synapses onto dendrites. They will next determine if levels of neurotrophins and cytokines predict the effectiveness of exercise in preventing the initiation of nicotine self-administration using blood samples that were collected prior to the first three self-administration sessions. Researchers have also begun parallel exercise studies in mice in order to benefit from transgenic and knockout technologies that manipulate nicotinic receptor expression. These studies will enable the researchers to determine the contributions of specific nicotinic receptor subunits to vulnerability to nicotine use during adolescence as well as to determine nicotinic receptor subtype contributions to exercise-related protection against nicotine use and relapse during adolescence. Reducing Teen Tobacco Use Via Text Messaging: Motivational Interviewing Integrated with Social Network Counseling Grant Award Amount (FY15): $149,958 Principal Investigators: Michael Mason, Ph.D., Department of Psychiatry, Commonwealth Institute for Child and Family Studies Collaborating Partners: Richmond Behavioral Health Authority The purpose of this study is to test an innovative intervention that seeks to interrupt tobacco use of a sample of Virginia youth using evidence-based messaging delivered via mobile phone text messages, and to characterize the geographic nature (density/ distance) of tobacco-selling outlets in relation to participating adolescents routine locations and examine the effects on tobacco use over time. Researchers will recruit 200 Richmond adolescents (ages 14-18) and randomize them to control or treatment groups. The participants will complete Ecological Momentary Assessments (EMA) every month and three follow-up assessments over six months Subject recruitment/enrollment began in May 2013 and finished recruiting in August Researchers employed a respondent-driven sampling plan, where participants could recruit up to three eligible friends for compensation. This method produced a steady flow of eligible participants into the study. Subjects were randomized into either the treatment group, who received interactive motivational interviewing with social network counseling text message interventions, or to the control group, who received general health information text messages. The control group text messages were matched in number to the intervention group. Each subject completed a baseline full battery online survey, received text interventions the first week after their enrollment, and completed ecological momentary assessments (EMA) brief phone-based survey every month and completed follow-up surveys at one, three and six months posttreatment. The first wave of EMAs started in the second week of June 2013 and the final wave of EMA concluded in the third week of February Utilizing repeated measures general linear models they examined the effects of the intervention while controlling for race, gender, age, presence of a smoker in the home and mental health counseling. At six months the experimental condition decreased the number of days smoked cigarettes (p<0.05) number of cigarettes smoked per day (p<0.01), increased intentions not to smoke in the future (p<0.05), increased peer social support among girls (p<0.05), and for boys, reduced the number of close friends in their networks who smoke daily (p<0.05) compared to controls. Effect sizes ranged from small to large. These results provide encouraging evidence of the efficacy of text messaging interventions to reduce smoking among adolescents and holds promise as a large-scale public health preventive intervention platform. The initial analyses indicated that this intervention had a positive effect on participants, and the analyses from the full sample have continued to support and reinforce this. This brief, novel intervention positively impacted adolescents tobacco use, social support and intentions to use tobacco in the future. Given that text-messaging is common among adolescents, protects privacy, is easily available and inexpensive, this intervention holds great potential in benefitting Virginia youth. 30 Virginia Foundation for Healthy Youth

31 Research The researchers at VCU are excited to continue to further develop this intervention. In the future, they want to examine the utility and impact of expanding the intervention in both length of time and personalization. Given the intervention s impact on adolescent smoking when it went only for five days, they are interested to learn how it would impact adolescent smoking over a longer time frame, with more personalization and being adaptive to the teen s current tobacco use. Can Parents Help Prevent Youth Tobacco Use? An Evaluation of Two Evidence-based Parenting Programs Grant Award Amount (FY15): $150,000 Principal Investigators: Rosalie Corona, Ph.D., Department of Psychology, VCU Clark-Hill Institute for Positive Youth Development Collaborating Partners: Richmond City Public Schools The overall goal of the proposed project is to determine the effectiveness of an evidence-based parent-focused program (Staying Connected with Your Teen) for decreasing adolescents tobacco use, intentions to use tobacco and other risk behaviors by increasing parental monitoring, improving parent-adolescent communication about tobacco use and the parent-child relationship in a sample of youth referred for truancy. The current project has several strengths including a focus on an understudied group of high-risk youth (i.e., youth who are truant) and has potential to contribute to the national and local discourse on youth tobacco prevention. Findings from this study could provide the local community with a new strategy for preventing tobacco use (i.e., self-directed programs) and also ways of engaging families in youth tobacco prevention efforts (i.e., using motivational interviewing techniques to increase families readiness for change). Key findings: To date, the researchers have collected baseline data from a total of 115 families (53 in the intervention group and 62 in the control group). Of the 115 families, 94 families have been eligible for their three-month assessment: 56 families completed the threemonth assessment (24 intervention, 32 control), one family is currently scheduled for their three-month assessment, eight are currently being recruited, and 29 declined or were ineligible. Seventy-eight families have been eligible for their eight-month assessment: 43 families completed this assessment (23 intervention, 20 control), one family is scheduled for their eight-month assessment, four are being recruited, and the remaining families (30) declined or were ineligible. Based on data that was ready for preliminary analysis from 98 families, caregivers ranged in age from 26 to 71 with a mean of years. The majority of caregivers were the adolescents biological mother (91%) and nearly all caregivers who participated were female (99%). A little over half of caregivers (58%) were single and had never been married; and 64% of caregivers had received a high school diploma or attended higher education. Caregivers reported race/ethnicity included 92% African American, 5% White, and 2% Latino (1% missing data). A majority of caregivers (64%) reported an annual income below $30,000. Twenty-nine percent of caregivers reported that their child had changed schools in the past year and 36% of caregivers had previously participated in a parenting program. Caregivers also reported on their lifetime substance use: 89% reported using alcohol, 63% used marijuana, 69% used cigarettes, 32% used cigars/cigarillos, 12% e-cigarettes and 58% said they had used tobacco products in front of their children. Adolescents ranged in age from 11 to 16 years (mean age = 12.97); 25.5% were in sixth grade, 38.8% in seventh grade, and 35.7% in eighth grade. Fifty-four percent of adolescents were male and 79.6% were African American. Twenty-four percent of adolescents had tried smoking cigarettes at some point in their lifetime, 20% ever tried alcohol and 17.3% tried marijuana. In the 30 days preceding the survey, 7% of adolescents reported using cigars/cigarillos. 31 Virginia Foundation for Healthy Youth

32 Financial STATEMENT OF NET ASSETS AND GOVERNMENTAL FUNDS BALANCE SHEET For the Fiscal Year Ended June 30, 2015 Governmental Funds Special Revenue ASSETS: Cash and cash equivalents held by the Treasurer of Virginia (Note 1-A) $11,813,761 *Investments Held by the Treasurer (Note 1-B) $0 Lease Deposits (Note 2-A) $5,966 Undeposited Funds/Prepaid Expenses (Note 2-B) $25,000 Capital Assets, net of accumulated depreciation: (Note 3) $0 Operating equipment $0 TOTAL ASSETS $11,844,727 LIABILITIES: Accounts Payable (Note 4-A) $5,248 Accrued Payroll (Note 4-B) $87,290 Obligations Under Security Lend (Note 1-B) $0 Grants Payable (Note 4-C) $665,063 Compensated absences (Note 5) $112,782 Total Liabilities $870,383 NET ASSETS: Investment in Capital Assets, net of related debt $0 Unrestricted $10,974,344 TOTAL NET ASSETS $10,974,344 The accompanying notes are an integral part of the financial statements * The Commonwealth s policy is to record unrealized gains and losses in the General Fund in the Commonwealth s basic financial statements. When gains or losses are realized, the actual gains and losses are recorded by the affected agencies. VFHY had none for this year. 32 Virginia Foundation for Healthy Youth

33 Financial STATEMENT OF ACTIVITIES AND CHANGES IN FUND BALANCE For the Fiscal Year Ended June 30, 2015 REVENUES: Master Settlement payments (Note 6) $9,350,407 Interest Income (Note 6) $0 Proceeds from securities lending transactions* (Note 1-B) $0 Grants and other revenues (Note 6) $42,527 TOTAL REVENUES $9,392,934 EXPENDITURES: Expenses Adjustments Net (Expense) Revenue and Changes in Net Assets Tobacco Settlement Expense: Administration (Note 7) $970,493 $0 -$970,493 Depreciation Expense (Note 3) $0 $0 $0 Expenses for Securities Lending (Note 1-B) $0 $0 $0 Marketing (Note 4-C) $2,919,132 $0 -$2,919,132 Program Expense (Note 8) $2,939,359 $0 -$2,939,359 Research and Evaluation (Note 9) $902,313 $0 -$902,313 Obesity (Note 8) $1,204,739 $0 -$1,204,739 Grant Program Expenses (Note 8) $15,000 $0 -$15,000 Inter-Agency Expenses (Note 10) $65,000 $0 -$65,000 State General Fund Transfers Out (Note 11) $49,978 $0 -$49,978 Total Expenditures $9,066,014 -$9,066,014 The accompanying notes are an integral part of the financial statements * The Commonwealth s policy is to record unrealized gains and losses in the General Fund in the Commonwealth s basic financial statements. When gains or losses are realized, the actual gains and losses are recorded by the affected agencies. VFHY had none this year. Excess (deficiency) of revenue over expenditures $326,920 Fund Balance/Net Assets, July 1, 2014 $10,647,424 Fund Balance/Net Assets, June 30, 2015 $10,974, Virginia Foundation for Healthy Youth

34 Financial NOTES TO FINANCIAL STATEMENTS As of June 30, 2015 Note 1:CASH, CASH EQUIVALENTS, AND INVESTMENTS A. Cash and Cash Equivalents Cash and cash equivalents represent cash in the General Account at the Department of the Treasury. Treasury manages the General Account Investment Portfolio. Information related to the composition of this portfolio is available on a statewide level in the Commonwealth of Virginia s Comprehensive Annual Financial Report. B. Securities Lending Transactions Investments and cash equivalents held by the Treasurer of Virginia represent the Virginia Foundation for Healthy Youth s (VFHY) allocated share of cash collateral received and reinvested and securities received for the State Treasury s securities lending program. Information related to the credit risk of these investments and the State Treasury s securities lending program is available on a statewide level in the Commonwealth of Virginia s Comprehensive Annual Financial Report. The Commonwealth s policy is to record unrealized gains and losses in the General Fund in the Commonwealth s basic financial statements. When gains or losses are realized, the actual gains and losses are recorded by the affected agencies. Note 2: LEASE DEPOSITS and RENTS A. VFHY rents office space at 701 E. Franklin for the main office and as of June 30, 2015, had field staff offices located in Blacksburg and Hayes, Virginia. B. Prepaid expenses are any payments made in the current fiscal year for expenses that will occur in the next fiscal year. Un-deposited funds represents funds received for current fiscal year but not in time for completion of deposit process. As of June 30, 2015, VFHY had funds to be deposited totaling $25,000. Note 3: CAPITAL ASSETS Capital assets, which include property, plant, equipment, and infrastructure assets, are reported in the governmentwide financial statements. The government defines capital assets as assets with an initial, individual cost of more than $ and an estimated life in excess of two years. The Virginia Foundation for Healthy Youth did not procure assets that would meet the capital asset requirements; therefore, they are maintained in an internal inventory control system. Note 4: LIABILITIES A. Accounts payable Operating expenses accrued but unpaid as of June 30, 2015, totaled $5,248. B. Accrued Payroll All VFHY employees are paid on a semi-monthly schedule. Accrued payroll expenses of $87,290 represents work performed prior to June 30, 2015 but registered in FY16 Commonwealth Accounting Reconciliation System. C. Grants/Contractual payables The VFHY awarded funding to programs all over the Commonwealth for the prevention of tobacco use and obesity by youths. The VFHY contracted with higher education universities to conduct research, surveys and evaluations on tobacco use and prevention. They also have contracts with marketing agencies to lead a major campaign geared toward youths throughout Virginia on the prevention of tobacco use and childhood obesity. At the end of the fiscal year there were outstanding payables for which VFHY had received invoices in the amount of $665,063. Cash with the Treasurer of Virginia... $ 11,464,943 Investments held by the Treasurer of Va... 0 Total cash, cash equivalents, and investments... $11,464, Virginia Foundation for Healthy Youth

35 Financial NOTES TO FINANCIAL STATEMENTS continued As of June 30, 2015 Note 5: COMPENSATED ABSENCES Compensated absences represent the amounts of annual, disability credits, and compensatory leave earned by VFHY employees, but not taken as of June 30, The $112,782 represents the balances at the fiscal year end provided by the Commonwealth s leave liabilities tracking program. $76,990 of the total is was determined to be long-term liability, according to the Commonwealth s GASB 34 long-term liability report. Note 6: REVENUES The VFHY is funded by receiving 10% of Virginia s share of the Master Settlement Agreement (MSA) negotiated between the various Attorneys General and the tobacco manufacturers in In FY 2015, VFHY received $9,350,407 in MSA payments and $0 in interest payments. VFHY did not receive the full 10% due to legislation that decreased the amount to 8.5% for the fiscal year and due to deposits made into a dispute escrow fund by participating tobacco manufacturers resulting from estimated decreases in market share to non-participating manufacturers. VFHY also received grant funds from VDH to broaden scope of services in community projects for prevention of obesity and tobacco use prevention, and conference and training registration fees from participants that was used to offset expenses. Note 7: ADMINISTRATION Administrative costs are all of the operating expenses needed for the maintenance of the VFHY. These include expenses of the Board of Trustees, some payroll (including accrued leave liabilities), rents, utilities, insurances, equipment (repairs, maintenance, rental and purchases), furniture and supplies, postage and delivery, printing, state vehicle fees, some employee travel and trainings. In addition, it includes expenses incurred for professional services provided by private industries such as temporary employees, marketing services, IT service, and website design and maintenance, etc. Note 8: PROGRAM and OBESITY Program and Obesity Expenses include funding provided to local organizations to conduct obesity and tobacco-use prevention programs with youth and expenses associated with administering the programs. Note 9: RESEARCH AND EVALUATION These expenses include the contracts and agreements with higher education universities in Virginia focused on the research, evaluation of tobacco use prevention programs, evaluation of the statewide marketing campaign as well as the Virginia Youth Survey. Note 10: INTER-AGENCY EXPENSE These include expenses incurred as a result of Memorandums of Understanding with agencies such as the Department of Health for fiscal and payroll support. Note 11: TRANSFERS Transfers out are to reimburse the General Fund for expenses related to the Office of the Attorney General, Department of Taxation, DGS, DOA, and DHRM. 35 Virginia Foundation for Healthy Youth

36 2015 ANNUAL REPORT 701 E. Franklin St., Suite 500 Richmond, VA (804)